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Occupational Health & Safety (Expert Forum)
Always been a +Reactor for TB, and have questions
Answered by
Philip Parks, MD - Occupational Safety, Occupational Health, Travel Medicine, Environmental Health
Harvard School of Public Health
Boston - MA
This forum is for questions and support regarding Occupational Health & Safety questions pertaining to: Blood Borne Exposures (Needle sticks), Chemical Safety-Spills-Exposure, Confined Spaces, Corporate Planning, Ergonomics, Fire Safety-Exposure, Industrial Hygiene, Hazard Communication, Hazardous Material Handling and Shipping, Health and Productivity Management, Indoor Air Quality, Injuries in the workplace, Noise-induced hearing loss, Nanotechnology and your health, Occupational Asthma, Pandemic Influenza (“FLU”), Personal Protective Equipment, Risk Communication, Safe Lifting Techniques, Workers compensation
Always been a +Reactor for TB, and have questions
by SickbutEmpowered, Mar 19, 2008 07:30AM
I don't know where else to put this question and I really would like some answers. I had tested positive for TB around the age of 2 or so. I am now 31. In the mid-90s when applying for work I was given a TB test and had a very bad reaction. At that time I didn't know I had been treated as a child for a year on Isoniazide. My chest x rays had been clear at the time, but I was treated of course anyways. After the re test I got sick from the test itself. I didn't look into in further. But now, I am a bit worried about a few things. Is it possible for an adult who was treated 22 years ago to develop some type of TB again? What I am concerned about is perhaps the infection was never in my lungs in the first place. Also, can the TB test itself cause a former TB reactor to get sick again with the actual disease? Is it possible that if it never was in my lungs, that it did not ever actually go away? In this case would I be contagious? I normally do not worry about these things, but I have been having what seems to be some kidney troubles lately, not for sure (and I don't think my new doctor considered) the history really yet because I just started seeing him. Yes, I want to feel better, but I don't want to be a risk to others if any of this is possible. Thank you for your time
Doctor's Answer
by Philip Parks, MD, Mar 20, 2008 10:06PM
, Mar 20, 2008 10:06PM
To: Sickbutempowed
Hello.
What kind of reaction did you have to the tuberculosis skin test? Blistering? Redness? Did your skin turn "hard" at this site of the test?
Where you born in the U.S.? If not, where were you born? (I ask this because TB is a much bigger problem outside the U.S.)? Was someone close to you infected with TB?
The treatment with isoniazid for one year was intended to treat what we call "latent TB." This means that you were treated even though you probably did not have symptoms at the time. The reason why we recommend treatment even though you have no symptoms (and a normal chest x-ray) is that TB infection is very dangerous and difficult to treat once patients become symptomatic. We are especially careful with children.
The treatment for latent TB only reduces the chance that you will develop TB (from the exposure to TB prior to taking the isoniazid). It is possible that you could be re-exposed TB after taking isoniazide and acquire latent TB again or acquire acute tuberculosis infection. So, isoniazid (or INH) does not function like a vaccine and does not offer protection against future exposures to TB.
The TB skin test cannot cause tuberculosis.
As long as you were not re-exposed to tuberculosis after your INH therapy, it is very unlikely that you will develop "reactivation TB" after having had the INH treatment.
I hope that this is helpful to you.
Please let me know if you have additional questions.
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
What kind of reaction did you have to the tuberculosis skin test? Blistering? Redness? Did your skin turn "hard" at this site of the test?
Where you born in the U.S.? If not, where were you born? (I ask this because TB is a much bigger problem outside the U.S.)? Was someone close to you infected with TB?
The treatment with isoniazid for one year was intended to treat what we call "latent TB." This means that you were treated even though you probably did not have symptoms at the time. The reason why we recommend treatment even though you have no symptoms (and a normal chest x-ray) is that TB infection is very dangerous and difficult to treat once patients become symptomatic. We are especially careful with children.
The treatment for latent TB only reduces the chance that you will develop TB (from the exposure to TB prior to taking the isoniazid). It is possible that you could be re-exposed TB after taking isoniazide and acquire latent TB again or acquire acute tuberculosis infection. So, isoniazid (or INH) does not function like a vaccine and does not offer protection against future exposures to TB.
The TB skin test cannot cause tuberculosis.
As long as you were not re-exposed to tuberculosis after your INH therapy, it is very unlikely that you will develop "reactivation TB" after having had the INH treatment.
I hope that this is helpful to you.
Please let me know if you have additional questions.
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
Member Comments (2)
by SickbutEmpowered, Mar 20, 2008 10:39PM
To: Dr. Parks
I have always lived in the United States. From my understanding my grandfather was a positive reactor as well. I don't know much about it because he died when I was young. The test they gave me when I was applying for work back in the nineties was the Tine test, not the single needle one. I for some reason had a bad reaction at the site, blistering and such but also had flu like symptoms and a sore throat afterwards. I don't understand why. My chest x ray was clear. I appreciate your help. No one I know has tested positive except for me. I guess I am afraid because now I am having some kidney problem. If something like this were to be the cause, how would I know. I am glad to know I couldn't have caught if from the Tine test. I have a low immune system (common variable immune deficiency) so that is why I worry that maybe it would reactivate or something. I just got over pneumonia and haven't had that since I was little. Anyways, thank you so much for your response. Peace and have a Happy Easter when it gets here.
